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Certificate of Insurance
UNITHAM-01 MSULLIVAN ACORO"° CERTIFICATE OF LIABILITY INSURANCE DAT8/5/2 D/YYYY) 022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Alliant Insurance Services,Inc. PHONE FAX 1050 Wilshire Dr Ste 210 (A/C,No,Ext): (248) 540-3131 (A/C,No):(248)203-7528 Troy, MI 48084 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURERA:Starr Indemnity& Liability Company 38318 INSURED INSURER B:Chubb Insurance Company of New Jersey 41386 United Hampshire US Real Estate Investment Trust INSURERC:Liberty Insurance Underwriters Inc 19917 22 Maple Avenue INSURER D: Morristown,NJ 07960 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MMIDD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE j OCCUR 1000305383211 12/31/2021 12/31/2022 DAMAGE TO RENTED 1,000,000 PREMISES Ea occurrence $ MED EXP An one person) $ 5,000 APPROVED BY RISKMhN MANAGEMENT 2,000,000 ,r✓.„ PERSONAL&ADV INJURY $ By /�yy/�`�r��y` - 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: OATLL� GENERAL AGGREGATE $ POLICY PRO � LOC WAVBRMA__YEs_ PRODUCTS-COMP/OPAGG $ 4,000,000 JECT OTHER: POLICY AGGREGAT $ 50,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 25,000,000 EXCESS LIAB CLAIMS-MADE 78195511 12/31/2021 12/31/2022 AGGREGATE $ 25,000,000 DED X RETENTION$ 0 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Excess Commercial Li 100038952803 12/31/2021 12/31/2022 $25MM xs$25MM 25,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Location:251 Key Deer Blvd,Big Pine Key,FL 33043 Named Insured:UH US Big Pine 2019 LLC CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West,FL 33040 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Starr Indemnity & Liability Company Dallas, TX 1-866-519-2522 ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT Policy Number: 1000305383211 Effective Date: 12/31/2021 at 12.01 A.M. Named Insured: United Hampshire US Real Estate Investment Trust This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION II - WHO IS AN INSURED, is amended to include as an additional insured: Any person or organization to whom you become obligated to include as en additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of your operations or premises owned by or rented to you. However, the insurance provided will not exceed the lesser of: • The coverage and/or limits of this policy, or • The coverage and/or limits required by said contract or agreement. All other terms, exclusions, and conditions of this policy remain unchanged. Signed for STARR INDEMNITY & LIABILITY COMPANY ? `�-------------- t 'W d ✓ ' Steve Blakey, IPr sident � Neilherniah B. Ginsburg, General Counsel OG 184(04/12) Page 1 of 1 Copyright©C.V.Starr&Company and Starr Indemnity&Liability Company. All rights reserved. Includes copyrighted material of ISO Properties,Inc.,used with its permission.